Individual
VAN AN YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2160
(859) 301-3932
Mailing address
PO BOX 932163, CLEVELAND, OH 44193-0001
(586) 412-4000
(586) 412-4100
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
41825
KY
2085R0202X
Diagnostic Radiology Physician
01062470A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
41825
KY
2085R0204X
Vascular & Interventional Radiology Physician
35.091510
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2849707
—
OH
05
—
7100055370
—
KY
01
—
P00644995
RRMC
—
01
—
P00825279
RAIL ROAD MEDICARE PTAN
KY
Enumeration date
03/20/2008
Last updated
06/13/2024
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